McGibbon C A, Krebs D E
Massachusetts General Hospital, Department of Orthopaedics, Boston 02114, USA.
J Rehabil Res Dev. 1999 Jul;36(3):173-82.
It is commonly accepted that leg muscle power is an important component of functional ability. Paced gait data for 20 healthy young women (27+/-4.2 yrs), 16 healthy old women (72.5+/-5.6 yrs), and 24 functionally limited old women (73.5+/-7.2 yrs) were analyzed during stance phase to investigate whether power calculations from motion analysis data were sensitive to impairments beyond the differences expected with aging. Healthy women included in the study functioned at a high/moderate level with no limitations, while functionally limited women functioned at a much lower level and exhibited one or more functional limitations as defined by the SF36 physical function scale. Single support time (SSUP), stance duration (SDUR), average forward center of gravity velocity (GVEL), and three-dimensional net power and work of the ankle (APOW/AWRK), knee (KPOW/KWRK), and hip (HPOW/ HWRK) were computed for the stance limb during the stance phase of gait. Univariate ANCOVA was used to examine which variables were most sensitive to functional limitations. We found that SDUR and SSUP were not different among the three groups when controlling for height and weight. Although differences in CG velocity between healthy and functionally limited old women were not significant, both elderly groups translated their CG slower than did the younger women (p<0.0001) when walking at the same cadence. Controlling for CG velocity eliminated all significant differences among groups except for APOW and AWRK in late stance phase between healthy and functionally limited elderly women (p<0.003). These results suggest that decreased ankle plantar-flexor power in late stance of gait may be an impairment-related characteristic more than an age-related characteristic.
人们普遍认为腿部肌肉力量是功能能力的重要组成部分。分析了20名健康年轻女性(27±4.2岁)、16名健康老年女性(72.5±5.6岁)和24名功能受限老年女性(73.5±7.2岁)在站立期的定速步态数据,以研究从运动分析数据计算得出的功率是否对衰老以外的损伤敏感。纳入研究的健康女性功能处于高/中等水平且无限制,而功能受限女性功能水平低得多,并表现出SF36身体功能量表定义的一种或多种功能限制。计算了步态站立期站立肢体的单支撑时间(SSUP)、站立持续时间(SDUR)、平均向前重心速度(GVEL)以及踝关节(APOW/AWRK)、膝关节(KPOW/KWRK)和髋关节(HPOW/HWRK)的三维净功率和功。使用单变量协方差分析来检查哪些变量对功能限制最敏感。我们发现,在控制身高和体重后,三组之间的SDUR和SSUP没有差异。尽管健康老年女性和功能受限老年女性之间的重心速度差异不显著,但在相同步频行走时,两个老年组的重心移动速度都比年轻女性慢(p<0.0001)。控制重心速度消除了各组之间的所有显著差异,但健康老年女性和功能受限老年女性在站立后期的APOW和AWRK除外(p<0.003)。这些结果表明,步态站立后期踝关节跖屈力量下降可能是一种与损伤相关的特征,而非与年龄相关的特征。